Anthony Scott Laney

Comparison of storage phosphor computed radiography with conventional film-screen radiography in the recognition of pneumoconiosis

Traditional film-screen radiography (FSR) has been useful in the recognition and evaluation of interstitial lung diseases, but is becoming increasingly obsolete. To evaluate the applicability of storage phosphor digital computed radiography (CR) images in the recognition of small lung opacities, we compared image quality and the profusion of small opacities between FSR and CR radiographs. We screened 1,388 working coal miners during the course of the study with FSR and CR images obtained on the same day from all participants. Each traditional chest film was independently interpreted by two of eight experienced readers using the International Labour Office (ILO) classification of radiographs of pneumoconiosis, as were CR images displayed on medical-grade computer monitors. The prevalence of small opacities (ILO category 1/0 or greater) did not differ between the two imaging modalities (5.2% for FSR and 4.8% for soft copy CR; p>0.50). Inter-reader agreement was also similar between FSR and CR. Significant differences between image modalities were observed in the shape of small opacities, and in the proportion of miners demonstrating high opacity profusion (category 2/1 and above). Our results indicate that, with appropriate attention to image acquisition and soft copy display, CR digital radiography can be equivalent to FSR in the identification of small interstitial lung opacities.

Occupational distribution of persons with confirmed 2009 H1N1 influenza.

Objective: To assess the distribution of illness by industry sector and occupation reflected in early 2009 H1N1 influenza surveillance. Methods: We analyzed data reported for April to July 2009, for 1361 laboratory-confirmed 2009 H1N1 influenza-infected persons 16 years or older, with work status information from four states. A North American Industry Classification System 2007 code was assigned to each employed person. For a subset, an occupation code was assigned. Results: Of 898 employed individuals, 611 (68.0%) worked in the non-health care sector. The largest proportions worked in public administration, educational services, and accommodation and food services. In Wisconsin health care personnel, 53.6% were paraprofessionals, 33.6% professionals, and 12.7% other workers; 26.9% worked in ambulatory settings, 46.2% in hospitals, and 26.9% in nursing or residential care facilities. Conclusions: Our findings suggest that industry sectors and occupations should be explored systematically in future influenza surveillance.

Agreement Between Fixed-Ratio and Lower Limit of Normal Spirometry Interpretation Protocols Decreases With Age Is There a Need for a New GOLD Standard?

Objectives: To assess concordance between the fixed 70% ratio cutoff point with the fixed percent predicted values (Fixed-ratio) and the lower limit of normal (LLN) algorithms in interpreting spirometry results in an older population. Methods: Spirometries were interpreted using Third National Health and Nutrition Examination Survey reference equations for 2319 workers. Results: The Fixed-ratio algorithm characterized 34.5% (n = 801) results as abnormal, compared with 29.7% (n = 689) by the LLN. There were almost twice as many obstructive and mixed airways spirometries identified under the Fixed-ratio compared to LLN. Rates of restrictive pattern physiology were virtually the same under each algorithm. Overall agreement between the algorithms decreased with age from “almost perfect” for those younger than 60 years to “substantial” for those older than 80 years. Conclusions: This study found age-related discordance between two algorithms possibly related to the lack of reference equations and standards for individuals older than 80 years.

Linking Compensation and Health Surveillance Data Sets to Improve Knowledge of US Coal Miners’ Health

Objective: Increase knowledge of US coal miners’ respiratory health by linking data from the black lung benefits program (BLBP) and the coal workers’ health surveillance program (CWHSP). Methods: BLBP claims data from 2000 through 2013 was linked to CWHSP data from 1970 through 2016. Results: Overall, 273,644 miners participated in CWHSP, 37,548 in BLBP, and 22,903 in both programs. Median age of miners at their time of first/only participation in CWHSP was 28 and 32 years, respectively. BLBP claimants were older (median age 59). Thirty-nine percent of BLBP claimants had not participated in CWHSP. The relative contributions of states to participation differed between CWHSP and BLBP. For example, Kentucky miners accounted for 18% of CWHSP participants, but 36% of BLPB participants. Conclusions: Many BLBP claimants never appeared in CWHSP, indicating missed opportunities for secondary prevention.

Current asthma and asthma-like symptoms among workers at a Veterans Administration Medical Center

INTRODUCTION Healthcare workers are at increased risk for respiratory disorders. The purpose of our respiratory health survey was to estimate the prevalence of current asthma and asthma-like symptoms and their association with workplace exposures and tasks among healthcare workers at a Veterans Administration (VA) Medical Center. MATERIAL AND METHODS Information on respiratory health and work characteristics, including tasks performed, products used, and exposures, were collected by questionnaire from a convenience sample of workers employed at the VA Medical Center during 2012-2014. Associations of asthma and asthma-like symptoms with cleaning and disinfecting tasks and products as well as exposure to dampness and molds, and construction dust were evaluated using log-binomial regression. RESULTS The prevalence of current asthma was 17.6% and almost half of all workers reported asthma-like symptoms. We observed elevated prevalence of current asthma among the VA healthcare workers compared to the U.S. general and working adult populations. Asthma and asthma-like symptoms were significantly associated with mold, dampness, and construction material exposures; cleaning and disinfecting products; and cleaning or disinfecting tasks. CONCLUSIONS Workplace exposures and tasks associated with current asthma and asthma-like symptoms were identified but further research is needed to investigate the temporal association between workplace exposures and current asthma and asthma-like symptoms.